United Nations Staff Mutual Insurance Society (UNSMIS) at Geneva

The Society is based at the United Nations Office at Geneva (UNOG). It was set up in 1949 under the United Nations Staff Rules. The Society is administered by an Executive Committee comprising members appointed by the Director-General of UNOG and the Staff Coordinating Council.

The Society reimburses serving and retired staff members of UNOG and international organizations with which UNOG has concluded an agreement (ITC, HCR, UNICEF, WMO in Geneva, UNV,UNFCCC, UNCCD in Bonn and UNSSC in Turin), subject to the Statutes and Internal rules in force, for the costs of medical care in the event of sickness, accident or childbirth.

Contact details

Membership: +41 (0)22 917 31 39

Reimbursements: +41 (0)22 917 31 35

Attestations, guarantees: +41 (0)22 917 20 19

Fax: +41 (0)22 917 02 98

Email: unsmis@unog.ch

Address

Palais des Nations
8-14, avenue de la Paix
1211 Geneva 10

Membership

Insurance Coverage

Extent of protection

The Society guarantees coverage at all times and in all countries. However, if an insured person decides to obtain medical care away from the duty station or place of residence of the Society member, the maximum sum reimbursable is the lowest cost of equivalent treatment provided in the canton of Geneva.

Prior authorization by the Medical Adviser

Prior authorization in writing by the Medical Adviser of the Society must be requested for certain medical benefits. The member should do this before incurring any expenses, by submitting the prescription for authorization to the Society, which will transmit it to the Medical Adviser. When an estimate is requested, it must be submitted to the Society together with the prescription, so that the Executive Committee can determine to what extent the Society will reimburse the amount of the estimate. Without prior authorization, the Society will refuse to reimburse the invoices.

Agreements with selected service providers

The Society allows you a free choice of doctor, pharmacist or medical establishment. However, in the interests of its members in general, the Society has concluded preferential agreements with a number of service providers. The list is provided by the Society upon request.

In the event of hospitalization in the United States, the member should, if possible, notify the Society before the date of your admission to hospital in order to facilitate the financial arrangements.

Accident and Third-party liability

When a third party may be liable for an illness or accident , the insured person must inform the United Nations Staff Mutual Insurance Society as soon as possible. He/she will then be invited to take all necessary steps to obtain full compensation for the injury from the third party. If someone is entitled to reimbursement from other sources for sickness or accident, the Society will reimburse only the portion that is not reimbursed by the other source, up to the amount normally covered.

Restrictions, forfeiture and suspension of benefits

Expenses in respect of the consequences of accidents occurring before the date of affiliation are not covered by the Society, nor are the cases of injury deliberately inflicted by the insured person on himself. Other limitations are specified in the Rules of the Society.

A member may forfeit his/her rights if it is established that the person concerned has attempted to obtain by fraud benefits to which he or she was not entitled or if the person refuse to undergo a medical examination prescribed by the Medical Adviser of the Society.

Premiums

Benefits

In the event of sickness, accident or maternity, the Society refunds medical expenses at the rates specified in its Internal rules. Members of the Society are personally liable for payment of the medical expenses for which they may claim reimbursement. The Society does not settle bills directly with members' creditors.

Expenses incurred in respect of any of the acts listed in the Internal rules, unless otherwise stated, shall be reimbursed at a rate of 80 per cent. For certain medical benefits the prior authorization of the Society must be requested in writing to the Medical Advisor. Such authorizations are only valid for a period of six months running from the date on which they are granted.

In the event of hospitalization, the Society will, upon request, issue insurance certificates or guarantees. Reimbursement is normally limited to 30 days' hospitalization per case. Prolongation of hospitalization beyond this time-limit is subject to the approval of the Society's Medical Adviser.

All claims must be made within twelve months of the date on which the relevant bill or account is established. Only staff members may make claims. Reimbursement is effected by the Financial Resources Management Service of the United Nations Office at Geneva. Expenditure incurred in currencies other than Swiss francs will be reimbursed in Swiss francs at the official United Nations exchange-rate applicable on the date of processing the invoice.

Medical benefits

Doctors' fees

Medical Imagery, laboratory analysis and tests

Out-patient medical fees in a medical establishment

Surgical operations (with the exception of aesthetic surgery)

Hospitalization in public ward or semi-private room in an establishment approved by the competent health authorities of the country concerned. The supplement for a private room is not reimbursable. Prior authorization is required over 30 days

Post-hospital and/or post-operation convalescence

Long-term hospitalization is limited to 365 days

Medical or paramedical benefits related to a long-stay in a medical establishment or medicalized nursing-home are limited to a maximum daily allowance

Benefits for care in the home are limited to a maximum daily allowance. Prior-authorization is required

Functional rehabilitation for prescribed treatments with a maximum allowance per session and a limited number of sessions per calendar year

Pharmaceuticals products reimbursable according to the criteria of the competent health authorities of the country concerned